Preparedness training programs improved the emergency response and crucial outcomes among nursing students:a scoping review

Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Databases through PubMed,Science Direct,and Google Scholar were used to obtain the relevant articles within the scoping review.Results:The researchers found 1175 articles.After manual review,28 articles were identified and assessed.The review reported that the emergency preparedness training program significantly affects preparedness,knowledge,performance,self-efficacy,learning motivation,self-confidence,satisfaction,critical decision-making,and problem-solving.Conclusions:Emergency training effectively increases knowledge,skills,confidence,satisfaction,and team performance.

Artificial Intelligence Based Meteorological Parameter Forecasting for Optimizing Response of Nuclear Emergency Decision Support System

This paper presents a novel artificial intelligence (AI) based approach to predict crucial meteorological parameters such as temperature,pressure,and wind speed,typically calculated from computationally intensive weather research and forecasting (WRF) model.Accurate meteorological data is indispensable for simulating the release of radioactive effluents,especially in dispersion modeling for nuclear emergency decision support systems.Simulation of meteorological conditions during nuclear emergencies using the conventional WRF model is very complex and time-consuming.Therefore,a new artificial neural network (ANN) based technique was proposed as a viable alternative for meteorological prediction.A multi-input multi-output neural network was trained using historical site-specific meteorological data to forecast the meteorological parameters.Comprehensive evaluation of this technique was conducted to test its performance in forecasting various parameters including atmospheric pressure,temperature,and wind speed components in both East-West and North-South directions.The performance of developed network was evaluated on an unknown dataset,and acquired results are within the acceptable range for all meteorological parameters.Results show that ANNs possess the capability to forecast meteorological parameters,such as temperature and pressure,at multiple spatial locations within a grid with high accuracy,utilizing input data from a single station.However,accuracy is slightly compromised when predicting wind speed components.Root mean square error (RMSE) was utilized to report the accuracy of predicted results,with values of 1.453℃for temperature,77 Pa for predicted pressure,1.058 m/s for the wind speed of U-component and 0.959 m/s for the wind speed of V-component.In conclusion,this approach offers a precise,efficient,and wellinformed method for administrative decision-making during nuclear emergencies.

Complete response of gallbladder cancer treated with gemcitabine and cisplatin chemotherapy combined with durvalumab:A case report and review of literature

BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.

Analysis of Monitoring,Early Warning and Emergency Response System for New Major Infectious Diseases in China and Overseas

In recent years,the impact of new major infectious diseases on people’s normal life is becoming more and more frequent,which has brought great impact on people’s life safety and social economy,especially the corona virus disease 2019,which has been sweeping the globe.Public health and disease prevention and control systems in different countries have different performances in response to the pandemic,but they all have exposed many shortcomings.Countries around the world urgently need to improve the monitoring,early warning and emergency response systems for new major infectious diseases.As the outpost and main part of medical rescue,the hospital urgently needs to establish a set of scientifically advanced emergency response mechanism that is suitable for the business process of the medical system and unified standards in order to improve the response efficiency and quality of emergency treatment.

Enlightenment from the COVID-19 Pandemic:The Roles of Environmental Factors in Future Public Health Emergency Response

The coronavirus disease 2019(COVID-19)pandemic is challenging the current public health emergency response systems(PHERSs)of many countries.Although environmental factors,such as those influencing the survival of viruses and their transmission between species including humans,play important roles in PHERSs,little attention has been given to these factors.This study describes and elucidates the roles of environmental factors in future PHERSs.To improve countries’capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic,a number of environmental factors should be considered before,during,and after the responses to such emergencies.More specifically,to prevent pandemic outbreaks,we should strengthen environmental and wildlife protection,conduct detailed viral surveillance in animals and hotspots,and improve early-warning systems.During the pandemic,we must study the impacts of environmental factors on viral behaviors,develop control measures to minimize secondary environmental risks,and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems.After the pandemic,we should further strengthen surveillance for viruses and the prevention of viral spread,maintain control measures for minimizing secondary environmental risks,develop our capability to scientifically predict pandemics and resurgences,and prepare for the next unexpected resurgence.Meanwhile,we should restore the normal life and production of the public based on the“One Health”concept,that views global human and environmental health as inextricably linked.Our recommendations are essential for improving nations’capability to respond to global public health emergencies.

Military-civilian cooperative emergency response to infectious disease prevention and control in China

In recent years, the incidence of severe infectious diseases has increased, and the number of emerging infectious diseases continues to increase. The Chinese government and military forces have paid a great deal of attention to infectious disease prevention and control, and using military-civilian cooperation, they have successfully prevented numerous severe epidemic situations, such as severe acute respiratory syndrome(SARS), influenza A(H1N1), avian influenza H5N1 and H7N9, and Ebola hemorrhagic fever, while actively maintained public health, economic development, and national construction. This paper focuses on the mechanisms of the military-cooperative emergency response to infectious diseases–the joint working mechanism, the information-sharing mechanism, the research collaboration mechanism, and the joint disposal mechanism–and presents a sorted summary of the practices and experiences of cooperative emergency responses to infectious diseases. In the future, the Chinese military and the civilian sector will further strengthen the cooperative joint command system and emergency rescue force and will reinforce their collaborative information-sharing platform and technical equipment system to further improve military-civilian collaborative emergency infectious diseases disposal, advance the level of infectious disease prevention and control, and maintain public health.

Evaluating Emergency Response Capacity of Chemical Industrial Park Using an Hybrid Fuzzy AHP Method

This paper presents an expert-based fuzzy analytic hierarchy process( AHP) model for evaluating emergency response capacity of Chemical Industrial Park( ERCCIP) by jointly using an improved fuzzy preference programming( FPP) and 2-tuple fuzzy linguistic approach. An evaluation index system for ERCCIP is proposed. The weight of sub-criteria and criteria of the evaluation index system for ERCCIP are determined using the improved FPP. And the ratings of sub-criteria are assessed in linguistic values according to the experts' subjective opinions. Finally,the aggregated ratings of criteria and the overall ERCCIP are calculated.

Factors Influencing the Emergency Medical Service Response Time for Cardiovascular Disease in Guangzhou, China

While emergency medical service (EMS) response time (ERT) is a major factor associated with the survival of patients with cardiovascular disease (CVD), relatively few studies have explored the factors associated with ERT. This study aimed to assess the current status of ERT and to identify the factors affecting ERT in patients with CVD in China. Between January 1, 2011 and December 31, 2015, EMS responses to CVD incidents in Guangzhou, China, were examined. The primary outcome was ERT, defined as the time from receipt of an emergency call to the arrival of paramedics on the scene. Factors associated with ERT were evaluated by multivariable logistic regression. A total of 44 383 CVD incidents were analysed. The median ERT was 12.58 min (interquartile range=9.98-15.67). Among the risk factors, distance (OR=13.73, 95% CI=11.76- 16.04), level of hospital (OR=1.57, 95% CI=1.40-1.75), and site of the incident (OR=1.53, 95% CI=1.38-1.69) were the top three significant factors affecting the ERT. Our results suggest that greater attention should be given to factors affecting the ERT. It is essential to make continuous efforts to promote the development of effective interventions to reduce the response time.

Dynamic Responses of A Semi-Type Offshore Floating Wind Turbine During Normal State and Emergency Shutdown

This paper addresses joint wind-wave induced dynamic responses of a semi-type offshore floating wind turbine（OFWT） under normal states and fault event conditions. The analysis in this paper is conducted in time domain, using an aero-hydro-servo-elastic simulation code-FAST. Owing to the unique viscous features of the reference system, the original viscous damping model implemented in FAST is replaced with a quadratic one to gain an accurate capture of viscous effects. Simulation cases involve free-decay motion in still water, steady motions in the presence of regular waves and wind as well as dynamic response in operational sea states with and without wind. Simulations also include the cases for transient responses induced by fast blade pitching after emergency shutdown. The features of platform motions, local structural loads and a typical mooring line tension force under a variety of excitations are obtained and investigated.

Fast and robust inversion of earthquake source rupture process and its application to earthquake emergency response

Fast inversion of source rupture process for significant earthquake is introduced and applied to earthquake emergency response. We retrieve and use the apparent source time functions （ASTFs） to stabilize the rupture process inversion, aiming to get the rupture process results correctly and quickly. The applications to 22 significant earthquakes occurred between January 2009 and July 2011 show an average inversion time consumed of about four hours, suggesting a high efficiency of this method, which much improves the inversion speed of the rupture process and is helpful in earthquake disaster mitigation and relief.

Patient tracking in earthquake emergency response in Iran： A qualitative study

BACKGROUND: After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran.METHODS: A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers. Participants were identified using a snow ball sampling method. Interviews were audiotaped, transcribed, coded, and entered into MAXQDA(version 10) for coding and content analysis.RESULTS: Three main themes and seven categories including content(recoding data), function(identification of victims, identification of the deceased, informing the patients' relatives, patients' evacuation and transfer, and statistical reporting), technology(the state of using technology) were identifi ed that showed the patient tracking status in past earthquakes in Iran.CONCLUSION: Participants believed that to identify and register the data related to patients or the dead, no consistent action plan was available. So developing a consistent patient tracking system could overcome this issue and improve patient safety.

Application of GIS to build earthquake emergency response system for urban area

A GIS based decision making system is designed for earthquake emergency response for city governments. The system could be used for seismic hazard assessment, earthquake damage and losses evaluation, emergency response and post earthquake recovering. The principle, design criteria, structure and functions of the system are described in detials. The system is composed of four parts: an information and data base, analytical modules, a decision making subsystem and a user interface. The information and data base consists of 68 coverages, including historically and instrumentally recorded earthquakes, seismo tectonic zones, active faults, potential source areas, isoseismals of scenario earthquake, soil profiles, characteristics of buildings, and all infrastructure systems such as: transportation network (roads and bridges, culverts), oil pipeline network, gas, water, electric power, communication etc., distribution of citizens, rush repair schemes of infrastructures and so on. There are also 28 analytical modules established in the system for generating isoseismals of scenario earthquake, site effects estimation, damage and losses evaluation and decision making for rescue, relief, evacuation and other emergency response actions. As an illustration, the operation of this system for reoccurrence of a historical earthquake is demonstrated.

The Training and Performance of Emergency Physicians as Anesthetists for International Medical Surgical Response Teams: The Emergency Physician’s General Anesthesia Syllabus (EP GAS)

Background: The availability of an anesthesiologist is often a limiting factor in the number of operations that can be performed by International Medical Surgical Response Teams (IMSuRT). Because emergency physicians (EPs) possess skills in airway control, management of moderate and deep sedation, and ventilator management, we propose that with proper training in general anesthesia, EPs can serve as anesthetists for IMSuRT with anesthesiologist supervision. Methods: During a 10-week period, a board-certified EP administered general anesthesia to 60 patients prior to a surgical medical mission trip. The breakdown of surgical cases was: 11 orthopedic, 2 genitourinary, 20 ear, nose, and throat, 8 obstetrics and gynecological, 13 general surgery, and 6 vascular. A simplified protocol for induction, maintenance, and emergence was adhered to for all cases. Results: Fourteen orthopedic cases using general anesthesia were performed in a one-week period in Haiti. These cases involved open reduction and internal fixation (ORIF), hemiarthoplasty, hardware removal, tendon transfer and external fixation of fractured bone. Conclusion: We demonstrate the feasibility of a model curriculum to train EPs in the basics of anesthesia. The EP can safely and effectively deliver general anesthesia for major cases on surgical medical mission trips under the auspices of an anesthesiologist in an austere environment.

Emergency Response for a Laboratory Biosafety Incident

On December 14, 2017, a faculty member of a university in Hunan Province reported that an anthrax vaccine strain might have recovered virulence during an undergraduate experiment and potential exposure could not be ruled out for the students involved. Upon receiving the case report, the CDC, health bureaus, and local governments at the county, prefectural, and provincial levels promptly organized experts in different fields (including epidemiologists, biosafety experts, and laboratory testing experts) for case investigation, evaluation, and response. As the investigation results showed, no virulence recovery was identified in the involved anthrax vaccine strain;and no contamination of Bacillus anthracis was detected at the involved areas. Thus, the university returned to normal functioning.

Coalition Emergency Response System, City Security and City Sustainable Development

The relations among the establishment of Coalition Emergency Response System （CERS）, city security and city sustainable development are analyzed in the article. According to the relation analysis, it is concluded that cities should build up their CERS to deal with the thread of damage in China. The recommendations about the establishment of the system are also provided.

Leveraging the Public Health Emergency Operation Center (PHEOC)for pandemic response: opportunities and challenges

Public Health Emergency Operation Center (PHEOC) was conceptualized and established for coordinatinginformation and resources towards goal-oriented response in large scale public health emergency. Yet, theactivities undertaken by PHEOCs and their intended goals have not been fully optimized in current scenario.This paper revisited the collective efforts invested in PHEOC conceptualization and development, identified theopportunities and challenges in compliance with standards and framework, demonstrated the accountabilityof PHEOC network, thereby promoted best practice guidance for global public health emergency preparednessand response. This review will help navigate emergency response complexities leveraging PHEOC partnershipsand advance the ability to detect and respond to public health emergencies in low resource settings. The reviewshows that the information on how to adapt best practice guidance to local circumstances could incentivizethe full implementation of prevention, early detection and response to outbreaks. Identifying and correctingdeficiencies in effectiveness evaluation will provide the basis for continuous PHEOC improvement. With thegradually reopening economies and public services in some countries, there is an urgent need to emphasize andvalidate the collective efforts undertaken by PHEOCs for tackling the COVID-19 pandemic.

Application of GIS technology in chemical emergency response

Responding to concerns raised by the Bhopal accident, more and more attention has been paid to local emergency, especially chemical emergency, prevention and planning worldwide, and many chemical emergency response systems for public response personnel have been built. With the successful application of geographical information system (GIS) technology in many fields, GIS can be an efficient tool for effective response to chemical emergencies. The purpose of this paper is to introduce the application of GIS technology in emergency response. Typical GIS technology is simply introduced and some of its existing applications to emergency, mainly natural disaster, response are summarized. Spatial data and spatial analysis requirements for chemical monitoring and emergency response are also discussed in detail. Finally a chemical monitoring and emergency response system under development by combining GIS and expert system for both chemical distribution centers and public response personnel is presented.

A framework for nuclear power plant emergency response system

The purpose of this study is to establish an intelligent expert system for nuclear power plant emergency response.A new framework of environmental risk management methodology by the concept of pattern recognition was introduced in this paper.A knowledge-based decision support system for emergency response and risk management of nuclear power plant was also discussed.The mathematical pattern relationship of accidental release effects on neighboring area and the corresponding response measures were presented in this paper.With this decision system,the decision maker can specify the procedure and minimize their human error in the decision process.The improvement of risk response and the quality of management system could be upgraded by this system.Besides,the methodology can also be served as a basis for the future development of environmental risk response system design.

Improved Emergency Response with TETRA

Ⅰ. EXECUTIVE SUMMARYAuthorities and emergency services used to be at the forefront of mobile communications–after all, respond-ing to emergencies has always required mobility. How-ever, the professionals’ technologically leading position has diminished with the explosive growth of